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At least 631 records · Page 35Linked to original sources
PubMed2004

Bronchoscopy in intensive care units.

Many situations exist imposing the use of bronchoscopy in intensive care units (ICU). There are many diagnostic and therapeutic indications. Interventional bronchoscopy represents a group of endoscopic techniques used in emergency or during the handling of different situations of airway obstruction. These situations seem quite frequent in paediatric ICU. This field has been developed with the availability of small endoscopes on the market and progress in instrumental and anaesthetic techniques.

Airway Obstruction↗
PubMed2004

Fluorescent bronchoscopy.

Detection of clinically occult lung neoplasms may represent an opportunity for early curative intervention. Fluorescent bronchoscopy is a sensitive technique for detecting early endobronchial tumors that may be combined with CT scanning as part of a comprehensive lung cancer screening program. Identification and longitudinal follow-up of dysplastic endobronchial changes with fluorescent bronchoscopy should facilitate studies of chemoprevention and further knowledge regarding the natural history of these lesions. Analysis of bronchial epithelium with novel techniques such as genomic hybridization and gene expression arrays might provide even better predictors of progression of dysplastic endobronchial lesions.

Bronchial Neoplasms↗
PubMed2004

[Flexible bronchoscopy in children: Indications and general considerations].

There is considerable interhospital variability in the practice of flexible bronchoscopy in children. The present report aims to provide some recommendations that are supported by the Spanish Society of Pediatric Pulmonologists. We review the indications, contraindications, equipment, setting and personnel involved in flexible bronchoscopy, as well as the pre-procedure preparation of the patient, medications, post-procedure monitoring, complications, care and maintenance of instruments, and informed consent. These recommendations may be adopted, modified or rejected according to clinical needs and constraints.

Anesthesia↗
PubMed1985

The use of dexamethasone in pediatric bronchoscopy.

The beneficial effect of intravenous corticosteroids in preventing traumatic laryngeal edema is controversial. Between 1968 and 1971, a controlled clinical study was conducted, at the American University of Beirut Medical Center, of 70 children who underwent bronchoscopy for removal of foreign bodies from the tracheobronchial tree. The patients were divided into two randomized groups; one group was given intravenous dexamethasone while the second was kept as a control. The length of hospitalization and the development of complications attributable to tracheobronchial edema were compared. Intravenous corticosteroids do not seem to reduce the incidence of post-bronchoscopy laryngeal edema.

Bronchoscopy↗
PubMed1999

Surgical simulation: an animal tissue model for training in therapeutic and diagnostic bronchoscopy.

A series of surgical simulation exercises has been developed using an animal model to allow trainees to practise basic instrument handling and develop psychomotor skills in bronchoscopy, without risk to patients. A pig model was found to be most suitable. After suitable preparation the model can be used for diagnostic and therapeutic exercises in bronchoscopy, including lavage, biopsy and the removal of various foreign bodies. The model is a safe, inexpensive and convenient means of bronchoscopic training for otolaryngology trainees. For the trained specialist who has to remove bronchial foreign bodies infrequently, the model is a useful way of maintaining skills.

Animals↗
PubMedDate not supplied

A pseudoepidemic of pulmonary fungal infections related to fiberoptic bronchoscopy.

During a three-week period a pseudoepidemic of fungal infections occurred involving patients from two different services. Trichosporon cutaneum and a Penicillium species were isolated from bronchial washings and sputa obtained after fiberoptic bronchoscopy on eight clinically uninfected patients. Investigation revealed contamination of cocaine solutions used for topical anesthesia during bronchoscopy. Contamination is thought to have occurred during preparation of the solutions by pharmacy personnel. Revision of techniques used in formulating and dispensing the solutions resulted in cessation of the pseudoepidemic.

Aged↗
PubMed2003

Comparison of transcutaneous and endtidal CO2-monitoring for rigid bronchoscopy during high-frequency jet ventilation.

OBJECTIVE: To compare endtidal and transcutaneous respiratory monitoring of high-frequency jet ventilation (HFJV) in rigid bronchoscopy. Both techniques provide a noninvasive measurement of pCO2. METHODS: High-frequency jet ventilation was applied via a rigid bronchoscope. Driving pressure (DP) was initially adapted to ensure normal ventilation. It was then changed twice by +/- 30% from the initial value. Endtidal and transcutaneous data were compared with arterial blood gas monitoring (ABG). RESULTS: Results were analyzed separately for the time just after changing the driving pressure (10 min) and the remaining time until the next change of the driving pressure (4 min). The first part was called the dynamic phase, and the second part the steady-state phase. Correlation coefficient between endtidal capnography and ABG was 0.96 for the steady state and 0.94 for the dynamic phase, respectively. Bland-Altman analysis revealed a bias of -0.21 kPa with limits of agreement (LOA) 1.63 kPa for the steady state and -0.25 kPa, 2.08 kPa for the dynamic phase, respectively. Correlation coefficient between transcutaneous monitoring and ABG for the steady state phase was 0.83, and was 0.72 for the dynamic phase. Bland-Altman analysis resulted in a bias of -0.89 kPa with LOA - 3.84 kPa during steady state and 0.92 kPa, 4.06 kPa for the dynamic phase, respectively. CONCLUSION: Endtidal capnography offers accurate respiratory monitoring of HFJV. Transcutaneous monitoring showed a good correlation to ABG only during steady-state conditions. For the dynamic phase the accuracy was significantly lower. Thus, we cannot recommend transcutaneous respiratory monitoring for the specific indication of rigid bronchoscopy using HFJV.

Adult↗
PubMed1999

The safety and usefulness of routine bronchoscopy before stem cell transplantation and during neutropenia.

Fibreoptic bronchoscopy with bronchoalveolar lavage (BAL) is used for clinical investigation and research into pulmonary complications of stem cell transplantation. Adverse effects of BAL are common in neutropenic patients with lung disease; there are few data on its safety when used routinely in transplant recipients without lung impairment. We describe the complications and usefulness for infection surveillance of routine BAL pre-transplantation and during neutropenia. Thirty-three patients before autologous or allogeneic BMT or PBSCT (B1) and 24 during post-transplant neutropenia (B2) underwent BAL; patients with pulmonary disease were excluded. Subjects were monitored for adverse effects, and BAL fluid was examined for pathogens. Complications of B2 were compared with events seen in 35 neutropenic patients who did not undergo BAL (C). Eighteen percent B1 and 33% B2 subjects showed complications of BAL. Fever occurred in 12% B1 and 26% previously afebrile B2 subjects, compared to 11% of C (P = 0.3). Epistaxis occurred in one B2 subject and two C. Potentially pathogenic organisms were isolated from 18% B1 and 13% B2 BAL fluids; none caused later respiratory infection. Bronchoscopy and BAL pre- and post-transplant had acceptable safety for a research procedure, but were not clinically helpful for infection surveillance.

Adolescent↗
PubMed2003

A prospective randomised controlled trial of capnography vs. bronchoscopy for Blue Rhino percutaneous tracheostomy.

A crucial step for successful percutaneous tracheostomy is the introduction of the needle and guide wire into the trachea. Capnography has recently been proposed as one way to confirm tracheal needle placement. In this randomised controlled study, we used capnography in 26 patients and bronchoscopy in 29 patients to confirm needle placement for percutaneous tracheostomy using Blue Rhino kit. The operating times and the incidence of peri-operative complications were similar for both groups. Capnography proved to be as effective as bronchoscopy in confirming correct needle placement.

Adolescent↗
PubMed2002

Cost-effectiveness of CT thorax and bronchoscopy in haemoptysis with normal CXR for exclusion of lung cancer.

As fibre-optic bronchoscopy and CT thorax become more widely used, patients with haemoptysis who had normal CXR and sputum results are more commonly offered both CT and bronchoscopy to exclude lung cancer. Doctors who are under possible litigation pressure arising from missed diagnoses of lung cancer are often exhaustive in their investigations, even when the haemoptysis has been transient. The present study aims to investigate the number of cancer patients who can be detected with the two investigations, and compare recent similar study results with archive results. We found that despite the use of more efficient investigation tools, the yield is paradoxically much lower and, hence, less cost-effective than that of previous studies. The likely reason is that doctors tend to over-investigate, even for short-term, minimal blood-streaked sputum, which is common among simple bronchitis. In order to be more cost-effective, these investigations should be used more selectively and for high risk patients such as those with prolonged haemoptysis and those who are heavy smokers.

Bronchoscopy↗
PubMed1996

Oxygen enrichment of entrained room air during Venturi jet ventilation of children undergoing bronchoscopy.

Intermittent oxygen jet ventilation at an inspiratory:expiratory ratio of 1:3 was used to ventilate 15 children undergoing rigid Storz bronchoscopy for removal of inhaled foreign body. Oxygenation of the patient was continuously monitored by pulse oximetry. In all children SpO2 was above 95% when the bronchoscope was above the carina. When the bronchoscope was introduced into one of the bronchi, SpO2 decreased to 70-85% in five children. Delivery of a continuous flow of oxygen via a T-piece attached to the side-arm of the bronchoscope increased the SpO2 > 95% in the five children. Oxygen jet ventilation during bronchoscopy is based on the Venturi principle; the oxygen jet will entrain room air from the side arm of the bronchoscope which functions as an entrainment orifice. This will decrease the FIO2. The FIO2 can be increased by flowing oxygen continuously via the T-piece attached to the side arm of the bronchoscope.

Adolescent↗
PubMed2004

Rigid bronchoscopy for foreign body removal: anaesthesia and ventilation.

Foreign body aspiration is a leading cause of death in children 1-3 years old, although mortality is low for children who reach the hospital. Presenting symptoms of an inhaled foreign body depends on time since aspiration. Immediately after inhalation the child starts to cough, wheeze, or have laboured breathing. If the early signs are missed, the child usually presents with fever and other signs and symptoms of chest infection. A plain chest X-ray has relatively low sensitivity and specificity for inhaled foreign body. The gold standard for diagnosis and management of this condition is rigid open tube bronchoscopy under general anaesthesia. For late presentations, time should be taken to fast the child and complete a thorough evaluation before bronchoscopy. The procedure should be performed in a well-equipped room with at least two anaesthesiologists, one with paediatric experience, in attendance. Most experienced anaesthesiologists prefer inhalational rather than intravenous induction of anaesthesia and a ventilating bronchoscope rather than intubation. Equally good results have been reported with spontaneous ventilation or positive pressure ventilation; jet ventilation is not advocated for foreign body removal in children.

Anesthesia↗
PubMed2003

Yield of bronchoscopy in the diagnosis of neoplasm metastatic to lung.

The yield of fiberoptic bronchoscopy (FB) in the diagnosis of pulmonary metastases has not been conveniently analyzed. With the advances in the surgery of pulmonary metastases, there is a need to evaluate the diagnostic yield and the usefulness of FB to exclude other diseases with similar radiological patterns. To determine the value of FB in the diagnosis of pulmonary metastases we have retrospectively analyzed our experience in 113 patients with proven pulmonary metastases. An endobronchial lesion was identified in 57/113 (50.4%). The most frequent tumors with endobronchial lesions were thyroid (100%), head-neck (67%) and breast carcinomas (59%). The highest diagnostic yield was obtained combining techniques of brushing, washing and biopsy (72.6%); in cases with endobronchial lesions (84.2%) and with certain histological types (head-neck 100%; breast 90.9% and colon 84.6%). The most frequent radiological findings were single or multiple nodules (77.9%). Atelectasis were associated with endobronchial lesions. In conclusion, bronchoscopy is a valuable diagnostic procedure in selected patients with metastatic lung disease.

Bronchoscopy↗
PubMed1986

Effects of transoral and transnasal fiberoptic bronchoscopy on oxygenation and cardiac rhythm.

The association of hypoxemia and cardiac arrhythmias with fiberoptic bronchoscopy (FOB) is known. The effects of various methods of inserting the bronchoscope on blood oxygen tensions, the true prevalence of arrhythmias, and the clinical significance of PaO2 and rhythm changes are poorly defined. Arterial blood gas values, oxygen saturation and cardiac arrhythmias detected by 24-hour Holter monitoring were compared in 20 male patients undergoing either transoral or transnasal FOB. No significant difference in oxygen saturation was found; however, PaO2 values fluctuated widely and unpredictably and were significantly higher in the eight patients in the transnasal FOB group. No life-threatening arrhythmias were induced during bronchoscopy; however, because of minor arrhythmias such as sinus tachycardia, the overall frequency of arrhythmias rose from 60% to 65%. The incidence of arrhythmias in this study was similar to that reported during pulmonary function testing.

Adult↗
PubMed1988

[Synopsis of computed tomography, scintigraphy and bronchoscopy in the diagnosis of bronchial carcinoma].

In 87 patients with histologically proven bronchogenic carcinoma, computerised tomography (CT) and bronchoscopy were performed to assess the accuracy of CT in detecting bronchial stenosis. Whereas patent airways and mainstem stenosis were recognised in 85% of the cases, the overall accuracy was only 57%. Furthermore, the results of both methods were compared to scintigraphy (ventilation, perfusion) to evaluate the functional impairment due to altered lung morphology and bronchial stenosis. With an increasing number of CT-diagnosed atelectatic or infiltrated segments an almost linear decrease in ventilation and perfusion values was observed. In comparison, bronchoscopy-diagnosed tumour stenosis resulted in decreased ventilation and perfusion data only if the lesion was centrally located.

Adenocarcinoma↗
PubMed1990

Bronchoscopy in critically ill patients. When is it appropriate?

Fiberoptic bronchoscopy is a valuable diagnostic and therapeutic tool for use in carefully selected patients with serious pulmonary disease. The authors review the benefits and risks of fiberoptic bronchoscopy and discuss the essentials of nursing care before, during, and after the procedure.

Airway Obstruction↗
PubMed1997

Tracheobronchial foreign bodies: a review of children admitted for bronchoscopy at King Fahd Specialist Hospital, Al Gassim, Saudi Arabia.

This is a review of 147 patients suspected of foreign body (FB) inhalation, admitted to King Fahd Specialist Hospital in Al Gassim, Saudi Arabia from July 1989 to December 1994. Age, sex, foreign body type and site, presenting symptoms and signs, radiological findings, diagnosis and complications are analyzed and discussed. All foreign bodies were removed by rigid bronchoscopy under general anaesthesia. The study highlights the magnitude of the problem in the region and reviews the clinical presentation of patients who have inhaled an FB and recommends bronchoscopy as a means of early diagnosis and management.

Age Distribution↗